Introduction
There was water in the beginning—abundant, refreshing, and providing everything the body requires to replenish the fluids it loses. For millions of years, it was the only beverage available to humans. With the advent of agriculture and animal domestication, milk became available. Then there’s beer, wine, coffee, and tea, all of which are consumed for the sake of flavor and pleasure as well as the fluids they provide. Soft drinks, sports and energy drinks, and the like provide hydration but with a hefty dose of unnecessary calories that the body may struggle to regulate. so, we should follow the healthy beverage guidelines.
With so many options, all of which have different, sometimes unexpected health effects, it’s easy to become confused about the “best” beverages for health. This prompted the formation of the independent Beverage Guidance Panel by a group of nutrition experts from across the United States. These six researchers, led by Dr. Walter C. Willett of the Harvard School of Public Health’s Department of Nutrition, reviewed the evidence on beverages and health and classified beverages into six levels based on calories delivered, contribution to energy and essential nutrient intake, and evidence for positive and negative health effects. The winner? Water. But that doesn’t mean that water is the only beverage that’s good for your health, or that everyone needs to drink eight glasses of water a day.
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Expert Recommendations on Beverage
The Beverage Guidance Panel distilled its recommendations into a six-tier pitcher, much like food experts did with the food pyramid. The group’s recommendations were published in the March 2006 issue of the American Journal of Clinical Nutrition. Each level is described below:
Level 1: Water
Water contains everything the body requires—pure H2O—to replenish fluids lost through metabolism, breathing, sweating, and waste removal. It’s the ideal drink for quenching thirst and rehydrating your body. It costs a fraction of a penny per glass when it comes from the tap. Water should be your go-to beverage most of the time.
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It is impossible to determine how much water the hypothetical average American requires each day. The amount you require is determined by how much you eat, the weather, and how active you are. So, rather than establishing an estimated average requirement for water as it has for other nutrients, the Institute of Medicine has established an adequate intake of 125 ounces (about 15 cups) for men and 91 ounces for women (about 11 cups). (5) Please keep in mind that this is not a daily goal, but rather a general guideline. Most people get about 80% of their calories from beverages, with the rest coming from food. So water is the most healthy beverage guidelines.
Level 2: Tea and Coffee
Tea and coffee are the world’s second and third most popular beverages, after water. They are calorie-free beverages brimming with antioxidants, flavonoids, and other biologically active substances that may be beneficial to health when consumed plain. Green tea, particularly the strong variety served in Japan, has received attention for its potential role in heart disease prevention, whereas coffee may help prevent type 2 diabetes. (2, 3) More research on the health benefits of tea and coffee is needed, but one thing is certain: adding cream, sugar, whipped cream, and flavorings can turn a healthy beverage into a not-so-healthy one. A 16-ounce Mint Mocha Chip Frappuccino with Chocolate Whipped Cream, for example, has 470 calories. This beverage (which is more of a dessert) contains 12 grams of saturated fat, nearly a day’s worth, and 71 grams of sugar, the equivalent of 17 teaspoons of sugar. (4) Keep in mind that the jury is still out on whether excessive coffee or caffeine consumption increases the risk of miscarriage in pregnant women, but it seems prudent to limit caffeinated beverages to one cup per day. Find out more about coffee and health.
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Level 3: Low-Fat and Skim Milk and Soy Beverages
Milk is an important source of calcium and vitamin D for children. For those who prefer not to drink cow’s milk, fortified soy milk is a good source of calcium and vitamin D. Both are high in protein and other essential micronutrients. Low-fat milk, sold as 1% or 1.5% milk, or skim milk, which is virtually fat-free, are the best options because they contain significantly less saturated fat than reduced-fat milk or whole milk, which contain 2% and 4% milk fat, respectively. Even low-fat milk is high in calories, and excessive consumption may increase the risk of prostate and ovarian cancer (for more information, see The Nutrition Source article Calcium and Milk: What’s Best for Your Bones and Health?). So it is a healthy beverage guidelines to drink 2 glass of milk per day, less is fine, as long as you get enough calcium from other sources. For growing children, the ideal amount of milk and calcium is less clear, but not pushing beyond two glasses of milk per day appears to provide sufficient nutrition without being excessive.
Level 4: Noncalorically Sweetened Beverages
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Diet sodas and other diet drinks are sweetened with calorie-free artificial sweeteners such as aspartame (Equal®, NutraSweet®, and others), saccharin (Sweet’N Low®, Necta Sweet®, and others), or sucralose (Splenda®); stevia, a calorie-free sweetener made from the leaves of a South and Central American shrub, is a new addition to the market. Because they are lower in calories, these diet drinks are preferable to sugar-sweetened soft drinks. However, the possibility that they may contribute to weight gain suggests that they are not a harmless substitute for water and should be consumed as a treat rather than a daily beverage. For those who find it difficult to give up full-calorie soda, these may be useful in making the transition to healthier beverages, like a nicotine patch can do for smokers.
Level 5: Caloric Beverages with Some Nutrients
Fruit juice, vegetable juice, whole milk, sports drinks, vitamin-enhanced waters, and alcoholic beverages all fall into healthy beverage guidelines. Each has advantages and disadvantages. Fruit juice contains the majority of the nutrients found in the fruit, but it usually provides more energy. As part of the daily fruit intake, the Dietary Guidelines for Americans recommend no more than one serving (4 ounces) of 100% fruit juice. Fruit smoothies are typically high in calories and should not be consumed on a daily basis. Although vegetable juice has fewer calories than fruit juice, it may be high in sodium. Whole milk is high in calcium and vitamin D, but it contains nearly twice as many calories as skim milk. With 4.5 grams of saturated fat per glass, whole milk is also a significant source of saturated fat. Sports drinks are lower in calories than soft drinks and contain less sodium, chloride, and potassium. Casual athletes and daily walkers do not require them. Endurance athletes who exercise for more than an hour at a time and sweat profusely are the only ones who require them. Meanwhile, vitamin-enhanced waters are unnecessary for anyone who takes a daily multivitamin, and adding vitamins to a sugary drink does not make it a healthier option. Alcohol may be beneficial to some but harmful to others, and entire books have been written on the subject (see The Nutrition Source article Alcohol: Balancing Risks and Benefits for more information).
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Level 6: Calorically Sweetened Beverages
The healthy Beverage Guidelines Panel designated beverages as “least recommended” if they are sweetened with sugar, high-fructose corn syrup, or other high-calorie sweeteners and contain few other nutrients. Carbonated and noncarbonated soft drinks, fruit drinks, lemonade, and other “ades” are examples. They are not recommended as a daily beverage because they contain so many calories and almost no other nutrients. Drinking these beverages on a regular basis can lead to weight gain and increase the risk of developing type 2 diabetes. This category also includes fruit smoothies, many flavored coffee and tea drinks, and some so-called energy drinks. Your body would be perfectly content if you only drank water. You would obtain all of your fluid requirements and all of your nutrients from food. However, with so many options, most people drink a variety of beverages. To provide some context for beverage selection, the Beverage Guidance Panel poured its recommendations into a pitcher (see our version above). The precise number of ounces isn’t important; these are given for a typical person who consumes 2,200 calories per day. The proportions are important. Here’s how the Panel recommends getting less than 10% of your daily calories from beverages:
- At least half of your daily fluid should come from water. For a person who needs 12 cups of fluid a day, that would mean six cups of water. More is fine—up to 100% of your daily beverage needs.
- About one-third (or about three to four cups) can come from unsweetened coffee or tea. If you flavor your coffee or tea with a lot of sugar, cream, or whole milk, then drinking less would help manage weight. If you take a pass on coffee or tea, choose water instead.
- Low-fat milk can make up another 20 percent, or about two 8-ounce glasses. Less is fine, just make sure you get your calcium from another source.
- A small glass (4 ounces) of 100% fruit juice, and no more than 1 to 2 alcoholic drinks for men or no more than 1 for women.
- Ideally, zero “diet” drinks made with artificial sweeteners, but up to 1 to 2 glasses (8 to 16 ounces) a day (this is adapted from the Beverage Guidance Panel’s original recommendation of up to 32 ounces per day).
- Ideally, zero drinks sweetened with sugar or high-fructose corn syrup, but up to a maximum of 8 ounces.
*Suggested healthy beverage guidelines pattern for a person requiring 2,200 calories per day, providing 10% of calories from beverages. The values 50, 28, 16, and 4 fluid ounces are shown for illustrative purposes only; the total should equal 98 fluid ounces, as shown at the top of the figure. The range listed at each level refers to the Beverage Guidance Panel’s recommended consumption range for each beverage. Caffeine is a limiting factor for coffee and tea consumption; up to 400 mg per day, or approximately 32 fluid ounces of coffee per day (can replace water). Noncalorically sweetened beverages can be used in place of tea and coffee, with the same caffeine limitations of up to 16 fluid ounces per day (this is an adaptation of the Beverage Guidance Panel’s original recommendation of up to 32 fluid ounces per day). Adapted with permission from the American Society for Nutrition’s Am. J. Clin. Nutr. (2006; 83:529-542).
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